16/07/2026
Three papers from June 2026, one through-line: the short-term signal you react to is often not the outcome that matters.
RELIEF's restrictive fluid arm showed more acute kidney injury in hospital. At four years, no excess chronic kidney disease — filtration-rate trajectories were superimposable. The acute creatinine rise was a poor proxy for lasting harm.
Pure oxygen at washout measurably collapses lung volume at extubation, a 643 mL greater reduction in end-expiratory volume one minute after extubation. But the effect clears within an hour, and 70 per cent oxygen gave the best post-extubation oxygenation.
Sugammadex beat neostigmine on extubation failure across 15,730 endoscopy patients, and the benefit held even in patients without chronic pulmonary disease.
Each recalibrates a default. None settles it. Weight a signal by the outcome that follows it, not the one in front of you.
Each paper carries its own evidence tier on the slide — seven slides walk through the study, the caveat, and the practice implication for each.
The full breakdown connects to Fluid Therapy, Renal Protection, Lung-Protective Ventilation, Emergence and Extubation, and Neuromuscular Reversal in AnaesthesiaVault, alongside question bank entries and flashcards on each topic.
Save this for your next journal club. Link in bio for the full breakdown.
PerioperativeMedicine FRCA FCA Medicine AnaesthesiaVault